Flexible conduit with locking element

ABSTRACT

A flexible conduit for insertion into a body lumen comprises a plurality of elements coupled end to end to define a conduit lumen. A first one of the elements includes a male portion and a female portion. A second element includes a female portion having an inner surface configured to engage a male portion of an outer surface of the first element to form a first ball joint. A third element includes a male portion, an outer surface of the male portion of the third element configured to engage an inner surface of the female portion of the first element to form a second ball joint. The male and female portions of the first element are adapted to frictionally engage the female portion of the second element and the male portion of the third element to establish a rigid connection therebetween.

PRIORITY CLAIM

This application claims the priority to the U.S. Provisional ApplicationSer. No. 61/096,529, entitled “Flexible Conduit with Locking Element”filed on Sep. 12, 2008. The specification of the above-identifiedapplication is incorporated herewith by reference.

BACKGROUND

Many procedures for the exploration and treatment of thegastro-intestinal (GI) tract involve the insertion of an endoscope intothe GI tract. During examinations, a user may navigate the GI anatomyusing a steerable endoscopic tip, or alternatively by performing aseries of torquing, pushing and pulling maneuvers at the proximal end ofthe device to advance and direct the distal end. The forces applied tothe endoscope are transferred to the surrounding tissue and may beproblematic and painful. Movement of the endoscope may cause spasms andmay, in certain cases, even perforate the intestine. It is thereforenecessary to perform the procedure slowly and at times, it may not bepossible to reach remote areas without unduly traumatizing surroundingtissue.

Various guides have been developed in order to absorb this stress andfacilitate insertion of the endoscope while minimizing the impact on thelumenal walls. However, the current guides are often expensive, bulkyand/or require added steps which unduly complicate the procedures.

SUMMARY OF THE INVENTION

The present invention is directed to a flexible conduit for insertioninto a body lumen, the conduit comprising a plurality of elementscoupled end to end with lumens of the elements aligned to define aconduit lumen. The plurality of elements include a first elementincluding a male portion and a female portion and a second elementincluding a female portion having an inner surface extending along acurve corresponding to a curve of the male portion of an outer surfaceof the first element so that, when the male portion of the first elementis received within the female portion of the second element, the firstand second elements form a first ball joint. A third element includes amale portion, an outer surface of the male portion of the third elementbeing curved along a shape corresponding to a curve of an inner surfaceof the female portion of the first element so that, when the maleportion of the third element is received within the female portion ofthe first element, the first and third elements form a second ball andsocket joint, the male and female portions of the first element beingadapted to frictionally engage respectively, the female portion of thesecond element and the male portion of the third element to establish arigidity of the conduit sufficient to retain its shape and absorb forcesapplied thereto as a flexible instrument is inserted through the conduitlumen.

BRIEF DESCRIPTION OF DRAWINGS

FIG. 1 is a perspective view showing an element of a flexible conduitaccording to a first embodiment of the invention;

FIG. 2 is a partial cross-sectional side view of the element of FIG. 1;

FIG. 3 is a perspective view showing multiple connected elements of aflexible conduit according to a first embodiment of the invention;

FIG. 4 is a partial cross-sectional side view of the flexible conduit ofFIG. 3;

FIG. 5 is a perspective view showing an element of a flexible conduitaccording to a second embodiment of the invention;

FIG. 6 is a partial cross-sectional side view showing the element ofFIG. 5;

FIG. 7 is a perspective view showing multiple connected elements of aflexible conduit according to a second embodiment of the invention;

FIG. 8 is a partial cross-sectional side view of the flexible conduit ofFIG. 7;

FIG. 9 is another partial cross-sectional side view showing forcesapplied to the flexible conduit of FIG. 7;

FIG. 10 is a perspective view showing forces applied to an element of aflexible conduit of FIG. 7;

FIG. 11 is a partial cross-sectional view showing the element of FIG. 9;

FIG. 12 is a side view of the element and forces shown in FIG. 9;

FIG. 13 is a side view showing another embodiment of a flexible conduitaccording to the invention, in a flexible state;

FIG. 14 is a side view showing the flexible conduit of FIG. 13 in alocked state;

FIG. 15 is a side view showing yet another embodiment of an element of aflexible conduit according to the invention; and

FIG. 16 shows a flexible conduit formed of the elements shown in FIG.15.

DETAILED DESCRIPTION

The present invention may be further understood with reference to thefollowing description and to the appended drawings, wherein likeelements are referred to with the same reference numerals. The presentinvention relates to guides for the insertion of flexible endoscopes orother flexible elongate instruments along tortuous body lumen paths. Theexemplary embodiments are described herein in conjunction with flexibleendoscopes. However, those skilled in the art will understand that theguides may be used to facilitate the insertion of any flexibleinstrument through a body lumen and that the discussion of endoscopes isexemplary only and is not intended to limit the invention. For example,embodiments of the flexible instrument guide according to the inventionmay be used to improve colonoscopy, enteroscopy, exploration of thebiliary tree, exploration of the GI tract and of extra-luminal space,among others. These methods and devices are useful for screening anddiagnostic purposes, as well as for the treatment of many conditions.

A guide according to the present invention is sufficientlylongitudinally flexible to be inserted along a path defined by anendoscope while remaining sufficiently longitudinally plasticallydeformable to ease insertion through the endoscope without kinking, asthose skilled in the art will understand. As the endoscope is insertedthrough the guide, the stress exerted outward from the endoscope to thebody lumen is absorbed by the guide and is not transferred tosurrounding tissue. The longitudinal rigidity of guides according tocertain embodiments of the invention may be varied during the procedureso that the guide may be inserted and removed while in a more flexiblestate and rigidized when it has assumed a desired shape. The guidesaccording to the invention are also preferably torsionally rigid tofacilitate the placement of distal ends thereof at desired locationsand/or in desired rotational orientations within the body. A workinglumen extending through the guides is sized to allow passagetherethrough of a flexible instrument to be used in accordance with anexemplary treatment procedure. Those skilled in the art will understandthat, as used in this application, the term axial refers to alongitudinal axis of the conduit (i.e., a path along which one of thediscrete elements of the conduit is situated) unless specificallydefined otherwise.

As shown in FIGS. 1-4, a guide according to a first embodiment of theinvention comprises a plurality of elements 100 connected together toform a conduit 150. Each of the elements 100 is substantially tubularand comprises a slotted portion with a curved outer surface formed of aunibody cylindrical disk, as will be described in greater detailhereinafter. Those skilled in the art will understand that, although theelements 100 are described as being substantially tubular, this refersto a shape of the elements 100 when linked together to form a conduitand does not require that the elements be strictly cylindrical.Generally, the elements 100 will have a substantially smooth, atraumaticouter surface with a cross-section which may be circular, elliptical orany other shape which facilitates the passing therethrough of selectedinstruments or which facilitates travel through target body lumens.

Each of the cylindrical elements 100 comprises a female portion 102 anda male portion 104 joined to one another. An inner surface 110 of thefemale portion 102 is sized and shaped to slidingly receive an outersurface 108 of the male portion 104 to form a ball and socket joint.That is, a curve of the inner surface 110 of the female portion 102 anda curve of the outer surface 108 of the male portion 104 are shaped andsized to closely fit one another while allowing for rotation about linessubstantially perpendicular to the longitudinal axis of the element 100.For example, the surfaces 108 and 110 may form parts of spheres with adiameter of the inner surface 108 exceeding that of the outer surface110 by a tolerance amount selected to maintain adjacent ones of theelements 100 bonded to one another while allowing the desired rotationand while providing a desired level of frictional engagement of themated elements 100. As would be understood by those skilled in the art,the level of frictional engagement between adjacent elements 100 may beadjusted through material choice, setting of the tolerance between thesurfaces 108 and 110 and by applying, for example, a surface treatmentto all or parts of the surfaces 108 and 110. The desired level offrictional engagement is set to achieve a desired resistance to bendingof the conduit 150 as an endoscope is inserted therethrough whilemaintaining a level of flexibility sufficient to enable the conduit 150to be slid through a body lumen along an endoscope without undulytraumatizing tissue. Furthermore, those skilled in the art willunderstand that the frictional engagement of adjacent elements 100 maybe adjusted to vary a degree of flexibility of the conduit 150 along itslength in any desired pattern. For example, a distal end portion of theconduit 150 may be formed with enhanced flexibility to enable thisdistal end portion to follow the full range of motion of a steerabledistal tip of an endoscope while a proximal portion of the conduit 150shows an increased resistance to bending.

In the exemplary embodiment, one or both of the male portion 104 and thefemale portion 102 is preferably formed of a material which isplastically deformable to aid in assembling the conduit 150. That is,such a material allows either or both of the male portion 104 and thefemale portion 102 to deflect as the male portion 104 is insertedthrough the female portion 102 and then return to its original shape asa point of maximum diameter of the surface 108 aligns with a point ofmaximum diameter of the surface 110. Examples of suitable materialsinclude plastics, such as, polypropylene, ABS, polystyrene, Nylon, etc.

In one exemplary embodiment, the ball and socket joint between adjacentelements 100 may allow approximately 30 degrees of rotation of theelements 100 relative to one another about a line substantiallyperpendicular to the axis. However, as described above, greaterflexibility may be desired in parts of the conduit 150 to, for example,allow for steering by the steerable distal tip of an endoscope (notshown). As shown in FIGS. 3 and 4, when many elements 100 are stackedtogether, a flexible conduit or catheter 150 having a solid but flexiblestructure is formed with a longitudinal lumen 112 extendingtherethrough. Those skilled in the art will understand that the rigidityof the conduit 150 may be varied significantly by changing any or all ofmaterials, surface treatments, tolerances, etc. to achieve a rigiditydesired for any given application. The radius of curvature may also bevaried by altering the tolerances and size of the components as would beunderstood by those skilled in the art. In one exemplary embodiment, theconduit 150 is designed to permit radii of curvature of 2.75 inches andgreater. However, those skilled in the art will understand that conduitsfor various applications may dictate different minimum radii ofcurvature. Depending on how a scope is anchored within a lumen and thestiffness of the conduit, a conduit such as the conduit 150 advancedthereover may act to straighten the endoscope or conform to the shape ofthe endoscope.

It may be useful to select a desired angular orientation of a distal endof the conduit 150 by transmitting a torque along the length of theconduit 150 from the proximal end of the conduit 150. According to thepresent invention, an optional linkage is provided between adjacentelements 100 that allows the conduit 150 to transmit a torque applied toits proximal end along its length to the distal end while retaining itslongitudinal flexibility. That is, the conduit 150 is torsionally stiffwhile remaining longitudinally flexible. As shown in FIGS. 1 and 3, oneor more protrusions 130 project radially outward from the outer surface108 of the male portion 104, each mating with a corresponding receptacle132 on the female portion 102. For example, a pair of protrusions 130may be located one opposite points of the male portion 104, separatedfrom one another by 180°. In one exemplary embodiment, the protrusion130 is substantially cylindrical although other shapes may be utilized.

The receptacles 132 are formed on the female portion 102 at locationscorresponding to the protrusion(s) 130 so that, when coupled to oneanother, each protrusion 130 of an element 100 is received within areceptacle 132 of an adjacent cylindrical element 100. For example,where the male portion 104 includes two projections 130 180° apart fromone another, these projections 130 are preferably offset by 90° from thereceptacles 132 of the same cylindrical element 100. When this firstcylindrical element 100 is mated to an adjacent second cylindricalelement 100, the projections 130 of the first element 100 are receivedin the receptacles 132 of the second element 100 with the second element100 rotated 90° relative to the first element 100. As a chain ofelements 100 is linked together, the individual elements 100 are eachoffset by 90° relative to the proximal and distal adjacent elements 100.Those skilled in the art will understand that the torsional stiffness ofthe conduit 150 is enhanced by selecting the dimensions of theprojections 130 and the receptacles 132 so that little, if any, play isallowed in the circumferential direction while a desired degree oflongitudinal flexibility is obtained by allowing axial movement of theprojections 130 relative to the receptacles 132 within which they arereceived. For example, where the projections 130 are substantiallycylindrical, the receptacles 132 may be formed as slots, a length ofwhich is selected to be greater than a diameter of the projections 130by a predetermined amount (e.g., wherein the projections 130 have adiameter of approximately 0.127 cm. the receptacles 132 may have alength of approximately 0.254 cm.), while the width thereof (i.e.,dimension in the circumferential direction) is selected to fit thediameter of the projections 130 with just enough clearance to allow theprojections 130 to slide axially in the receptacles 132. Thisarrangement allows torque to be efficiently transmitted along the lengthof the conduit 150.

Those of skill in the art will understand that the details of thefeatures and of the slots formed on the cylindrical elements 100 may bevaried. For example, the position of the slots and protrusions may beinterchanged, so that protrusions extending inward from the innersurface 110 are received in slots formed in the outer surface 108. Othershapes may be used to transmit a rotational force, such as ridgesprotruding from both elements, keyways, etc. According to the invention,any combination of features that prevents relative rotation of adjacentcylindrical elements 100 while permitting longitudinal flexibility maybe used.

As shown in FIGS. 5-16, alternative embodiments of the present inventionallow for dynamic adjustment of the stiffness of the conduit so that theconduit may be placed in a flexible state as it is slid along anendoscope and then stiffened to absorb forces applied as the endoscopeis inserted further into the body lumen. According to the invention,application of a force directed radially outward within the lumen 112forces the male portion 104 to exert a force on the female portion 102within which it resides, thus increasing the friction between the outersurface 108 and the inner surface 110 of the adjacent elements 100. Theincreased frictional resistance between the adjacent elements 100increases the longitudinal stiffness of the conduit 150. In cases whereflexibility is desired, the radial force is reduced or withdrawnentirely to reduce the frictional resistance between adjacent elements100.

As shown in FIGS. 5-11, an element 200 of a conduit 300 is formedsubstantially similarly to the elements 100 of the conduit 150 exceptthat the male portion 204 is slotted to form a plurality of tabs 220separated from one another by slits extending substantially parallel tothe longitudinal axis of the conduit 300 enhancing the ability of themale portion 204 to flex radially outward from the axis.

Each of the cylindrical elements 200 comprises a female portion 202 anda male portion 204 joined to one another to form a unitary element 200.As with the elements 100, an inner surface 210 of the female portion 202is sized and shaped to slidingly receive an outer surface 208 of themale portion 204 to form a ball and socket joint. A curve of the innersurface 210 of the female portion 202 and a curve of the outer surface208 of the male portion 204 are shaped and sized to closely fit oneanother while allowing for rotation about lines substantiallyperpendicular to the axis. However, if desired, the elements 200 may bemore loosely joined to one another than the elements 100 to form aconduit 300 which, in an unstressed state, is more flexible than theconduit 150. For example, the surfaces 208 and 210 may form parts ofspheres (or any other suitable curves) with a diameter of the innersurface 208 exceeding that of the outer surface 210 by a toleranceamount selected to maintain adjacent ones of the elements 200 bonded toone another while allowing the desired rotation.

As described above, the male portion 204 is divided into a plurality oftabs 220 separated from one another by slits 222. The slits 222 providea clearance so that the tabs 220 can deflect radially outward from theaxis of the lumen 212 extending through each cylindrical element 200.The material forming the male portion 204 is preferably elastic so that,after being deflected by an external force, the tabs 220 return to theiroriginal shape and location. For example, as the male portion 204 of oneelement 200 is inserted into the female portion 202 of another element200, the tabs 220 deflect inward and then return to their original shapeas a point of maximum diameter of the surface 208 aligns with a point ofmaximum diameter of the surface 210. The curvature of the inner andouter surfaces 208, 210 serves to couple adjacent elements 200 together.

Those skilled in the art will understand that the number of slits 222and of tabs 220 may be varied to achieve a desired degree of flexibilityof the resulting conduit 300. The shape of the tabs 220 may also bevaried with the tabs 220 of any element 200 being identical to oneanother or including two or more different shapes. For example, anexemplary embodiment comprises two slits defining two identical tabs. Inanother example, eight substantially identical tabs 220 are placedsymmetrically around the longitudinal axis of the conduit. In yetanother example, the tabs 220 are different from one another and mayalso be placed at variable intervals around the circumference of theelement 200.

In one exemplary embodiment, the ball and socket joint between adjacentelements 200 allows about 30 degrees rotation of the elements relativeto one another about a line substantially perpendicular to the axis. Asshown in FIGS. 7 and 8, when many elements 200 are stacked together, aflexible conduit or catheter 300 having a solid but flexible structureis formed with a longitudinal lumen 212 extending substantially thelength of the conduit 300. In addition, as described above, theflexibility of the conduit 300 may be varied along its length by any ofthe manners mentioned above in regard to the conduit 150 to achieve thesame goals.

In addition, the conduit 300 may be made torsionally stiff through theinclusion of a linkage similar to that described above in regard to theconduit 150. As shown in FIGS. 5 and 7, one or more protrusions 230project radially outward from the outer surface 208 of the male portion204. In one exemplary embodiment, the protrusion 230 is substantiallycylindrical although other shapes may be utilized. For example, a pairof protrusions 230 may be located one opposite points of the maleportion 204, separated from one another by 180°.

A receptacle 232 is formed on the female portion 202 at a locationcorresponding to each protrusion 230 so that, when coupled to oneanother, each protrusion 230 of a cylindrical element 200 is receivedwithin a receptacle 232 of an adjacent cylindrical element 200. Forexample, where the male portion 204 includes two projections 230 180°apart from one another, these projections 230 are preferably offset by90° from the receptacles 232 of the same cylindrical element 200. Whenthis first cylindrical element 200 is mated to an adjacent secondcylindrical element 200, the projections 230 of the first element 200are received in the receptacles 232 of the second element 200 with thesecond element 200 rotated 90° relative to the first element 200. As achain of elements 200 is linked together, the individual elements 200are each offset by 90° relative to the proximal and distal adjacentelements 200. Those skilled in the art will understand that thetorsional stiffness of the conduit 300 is enhanced by selecting thedimensions of the projections 230 and the receptacles 232 so thatlittle, if any, play is allowed in the circumferential direction while adesired degree of longitudinal flexibility is obtained by allowing axialmovement of the projections 230 relative to the receptacles 232 withinwhich they are received. For example, as described above where theprojections 230 are substantially cylindrical, the receptacles 232 maybe formed as slots, a length of which is selected to be greater than adiameter of the projections 230 by a predetermined amount, while thewidth thereof (i.e., dimension in the circumferential direction) isselected to fit the diameter of the projections 230 with just enoughclearance to allow the projections 230 to slide axially in thereceptacles 232. This arrangement allows torque to be efficientlytransmitted along the length of the conduit 300.

Those of skill in the art will understand that the details of thefeatures and of the slots formed on the cylindrical elements 200 may bevaried. For example, the position of the slots and protrusions may beinterchanged, so that protrusions extending inward from the innersurface 210 are received in slots formed in the outer surface 208. Othershapes may be used to transmit a rotational force, such as ridgesprotruding from both elements, keyways, etc. According to the invention,any combination of features that prevents relative rotation of adjacentcylindrical elements 200 while permitting longitudinal flexibility maybe used.

The embodiments according to the present invention provide for theconduit to have a stiffness which can be dynamically adjusted by a user.Application of a force F₁ directed radially outward against the flexibletabs 220 causes the male portion 204 to press more firmly against thefemale portion 202 of an adjacent element 200 increasing the frictionbetween the outer surface 208 and the inner surface 210. This impedesrelative movement between the adjacent elements 200, increasing thelongitudinal stiffness of the conduit 300. FIGS. 9-12 show a schematicrepresentation of exemplary forces F₁ acting on the tabs 220 in theradial direction to stiffen the conduit 300.

Various methods of applying the adjustable radial force F₁ to theflexible tabs 220 may be used according to the invention, as will bedescribed below. In one exemplary embodiment, the radial force F₁ isprovided by an inflatable element (not shown) located radially inward ofthe tabs 220. The inflatable element (e.g., a balloon) is coupled to asupply of inflation fluid operable by the user to expand and deflate theinflatable element (not shown) so that a pressure in the inflatableelement adjusts a magnitude of the force F₁ applied to the radiallyinner surfaces of the cylindrical element 200 and, specifically, theflexible tabs 220. As the exemplary female portion 202 is substantiallyrigid, it is not significantly affected while the flexible tabs 220 ofthe male portion 204 are deflected radially outward to press against theinner surface 210 of the adjacent element 200 to vary the force F₁exerted on the flexible tabs 220 and the friction between the adjacentelements 200 to a desired level.

In one exemplary embodiment shown in FIGS. 13 and 14, a conduit 400 isformed by joining together a plurality of elements 402 defining a lumen412 that may be used, for example, to provide a passage for a scope orfor other medical instruments. An optional coil spring 414 is placed inthe lumen 412 to stabilize it, especially when in the flexible stateshown in FIG. 13 and an outer cover 416 is placed over outer surfaces ofthe cylindrical elements 402, to protect the internal components of theconduit 400. For example, the outer cover 416 may comprise a braidand/or a PVC cover.

Each of the exemplary cylindrical elements 402 is formed of a maleportion 404 and a contiguous female portion 406 similar to the male andfemale portions 204, 202, respectively, described above. As describedabove, the male portion 404 of one element 402 fits in the femaleportion 406 of an adjoining element 402. Both male and female portions,404, 406 have opposing curved surfaces that slide one over the other, toform a ball and socket joint as described above in regard to theelements 200. The male portions 404 comprise tabs (not shown) that canbe flexed radially outward to press against the female portions 406 andadjust a longitudinal stiffness of the conduit 400.

According to the invention, a hydraulic balloon sleeve 410 is disposedradially inward of inner surfaces of the cylindrical element 402, alongthe length of the variable conduit 400. FIG. 13 shows the conduit 400 ina flexible state in which the hydraulic balloon sleeve 410 is deflatedand applies no outward force to the male elements 404. When an inflationfluid (e.g., water) is introduced under pressure to the hydraulicballoon sleeve 410 as shown in FIG. 18, outer surfaces of the balloonsleeve 410 move radially outward, flexing the male elements 404 radiallyoutward against the female elements 406 to increase friction betweenadjacent elements 402 and enhance the rigidity of the conduit 400.

As would be understood by those skilled in the art, alternativeembodiments of the invention may be devised, where the relative positionof the male elements, female elements and inflatable elements arechanged. For example, the inflatable element may be radially outside thecylindrical elements, such that inflating it produces a radially inwardforce which presses against the cylindrical elements. In thisembodiment, the female elements may flex radially inward to engagesubstantially rigid male elements to increase a stiffness of theconduit. In other embodiments, a force may be applied to frictionalelements that do not face in a radial direction, such that thedeflection of the friction elements and/or the force acting on them isnot in the radial direction.

As shown in FIGS. 15 and 16, a conduit 450 according to anotherembodiment of the invention comprises multiple substantially cylindricalelements 452 stacked together in a manner similar to that of theabove-described embodiments. As described above, each cylindricalelement 452 has a male portion 454 that fit in and interlocks with afemale portion 456 of an adjacent element 452 to allow longitudinalflexing of the adjacent elements 452 relative to one another about anaxis perpendicular to a longitudinal axis of the conduit 450 whilepreventing relative rotation between adjacent elements 452 about thelongitudinal axis. The male and female portions 454, 456 slide relativeto one another on opposite curved surfaces forming a ball and socketjoint as described above.

A hydraulic or pneumatic inflatable element 460 disposed within thelumen 462 of the conduit 450 may be, for example, a balloon catheter orsimilar device. As shown in FIG. 15, when inflated, an inflatableelement 460 applies a substantially radial force F₂ outward against themale portion 454 to frictionally engage the female portion 456 of theadjacent element 452 to rigidize the portion of the conduit 450. FIG. 16shows a similar arrangement with a more extensive conduit 450 includinga more elongated element 460 inflated with, for example, water, air oranother fluid to apply radially outward force to the male portions 454of a plurality of elements 452 to rigidize this portion of the conduit450 in the same manner described above in regard to FIG. 15. Thoseskilled in the art will understand that the length of the rigidizableportions of the conduit 450 may be varied and that a single element 460may rigidize a substantial portion of the length of the conduit 450,only a selected smaller portion or that multiple elements 460 may beemployed to dynamically alter the rigidity of various sections of theconduit 450 independently of one another. In the mean time, the conduit450 may optionally include one or more portions which are alwaysrelatively flexible (i.e., which are not acted on by inflation of anelement 460) in any desired pattern.

Those skilled in the art will understand that any other suitablearrangement for imparting a radial force to deflect an element of such aball and socket joint to selectively enhance the frictional engagementof adjacent elements may be employed without departing from the scope ofthe invention. For example, in place of an inflatable element, a springlike structure or mesh may be mechanically expanded and constricted. Inaddition, as described above, this force may be directed radially inwardto deflect a radially outer element against a radially inner element orvice versa.

By varying a pressure at which the inflation fluid is supplied thestiffness of the conduit may be varied to a desired level up to andincluding levels required to resist forces to which the conduit islikely to be exposed in the environment within which it is to bedeployed. That is, conduits according to the invention may be made stiffenough to retain their shape against anatomical forces to which theywill likely be exposed as well as to resist bending forces appliedthereto by flexible instruments such as endoscopes insertedtherethrough. As would be understood by those skilled in the art, anyconventional pump, compressor, storage device for pressurized fluid orother device may be used to provide the fluid used to inflate theexpandable inflatable elements according to the invention.

The present invention has been described with reference to specificexemplary embodiments. Those skilled in the art will understand thatchanges may be made in details, particularly in matters of shape, size,material and arrangement of parts. Accordingly, various modificationsand changes may be made to the embodiments. The specifications anddrawings are, therefore, to be regarded in an illustrative rather than arestrictive sense.

1-25. (canceled)
 26. A flexible conduit, comprising: a plurality ofelements, wherein each element has a lumen, and the plurality ofelements are coupled together with the lumens aligned to define aconduit lumen, the plurality of elements including: a first elementincluding a male portion and a female portion; and a second elementincluding a female portion sized to slidingly receive therewithin themale portion of the first element, an outer surface of the male portionof the first element being curved along a shape corresponding to a curveof an inner surface of the female portion of the second element; and aforce applying mechanism to apply a radial force to at least one of theplurality of elements to adjust a frictional force between the firstelement and the second element to adjust a stiffness of the flexibleconduit.
 27. The flexible conduit according to claim 26, wherein theforce applying mechanism includes at least one of an inflatable elementand a mechanical element.
 28. The flexible conduit according to claim27, wherein the inflatable element, when inflated, applies a radiallyoutwardly directed force to the first element urging the first elementradially outward into engagement with the second element.
 29. Theflexible conduit according to claim 28, wherein the radially outwardlydirected force is applied to the male portion of the first element tourge the male portion of the first element radially outward intoengagement with the female portion of the second element.
 30. Theflexible conduit according to claim 27, wherein the inflatable elementis one of a balloon and an inflatable sleeve.
 31. The flexible conduitaccording to claim 27, wherein the inflatable element, when inflated,produces a radially inwardly directed force to press the first elementand the second element into engagement.
 32. The flexible conduitaccording to claim 31, wherein the radially inwardly directed force isapplied to the female portion of the second element to urge the femaleportion of the second element radially inward into engagement with themale portion of the first element.
 33. The flexible conduit according toclaim 26, further comprising a flexible sheath surrounding at least partof the first element and the second element to present a smooth exteriorsurface of the flexible conduit.
 34. The flexible conduit according toclaim 26, wherein at least one of the outer surface of the male portionand the inner surface of the female portion of the first element issurface treated to enhance a frictional coupling with a surface matedthereto.
 35. The flexible conduit according to claim 26, wherein theouter surfaces of the male portions of the first element and the secondelement are formed as partially spherical surfaces having a firstdiameter, and wherein the inner surfaces of the female portions of thefirst element and the second element are formed as partially sphericalsurfaces having diameters greater than the first diameter.
 36. Theflexible conduit according to claim 26, further comprising a coil springstabilizer disposed at least partially in the conduit lumen.
 37. Aflexible conduit, comprising: a plurality of elements, wherein eachelement has a lumen, and the plurality of elements are coupled togetherwith the lumens aligned to define a conduit lumen, the plurality ofelements including: a first element including a male portion and afemale portion; and a second element including a female portion sized toslidingly receive therewithin the male portion of the first element, anouter surface of the male portion of the first element being curvedalong a shape corresponding to a curve of an inner surface of the femaleportion of the second element; a force applying mechanism to apply aradial force to at least one of the plurality of elements to adjust africtional force between the first element and the second element toadjust a stiffness of the flexible conduit; a first projection extendingfrom one of the first element and the second element to mate with afirst receptacle formed on the other of the first element and the secondelement to limit relative rotation therebetween about a longitudinalaxis of the flexible conduit; and a second projection extending from oneof the first element and the second element mating with a secondreceptacle formed on the other of the first element and the secondelement, the second receptacle including a second slot having a lengthin a direction substantially parallel to the longitudinal axis of theflexible conduit selected to permit a desired degree of relative axialmovement between the first element and the second element.
 38. Theflexible conduit according to claim 37, wherein the first receptacleincludes a first slot having a length to permit a desired degree ofrelative axial movement between the first element and the secondelement.
 39. A flexible conduit, comprising: a plurality of elements,wherein each element has a lumen, and the plurality of elements arecoupled together with the lumens aligned to define a conduit lumen, theplurality of elements including: a first element including a maleportion and a female portion; and a second element including a femaleportion sized to slidingly receive therewithin the male portion of thefirst element, an outer surface of the male portion of the first elementbeing curved along a shape corresponding to a curve of an inner surfaceof the female portion of the second element; and a force applyingmechanism to apply a radial force to at least one of the plurality ofelements to adjust a frictional force between the first element and thesecond element to adjust a stiffness of the flexible conduit; whereinthe male portion of the first element includes a plurality of flexibletabs separated from one another by slits extending substantiallyparallel to a longitudinal axis of the flexible conduit.
 40. Theflexible conduit according to claim 39, wherein the force applyingmechanism applies the radial force to the plurality of tabs to flex theplurality of tabs radially outward.